SPACE - The impact of structural interventions to promote physical activity among children and adolescents

Purpose and target group
The purpose of the research project is to develop, document and assess a comprehensive intervention in local districts in an effort to promote everyday moderate physical activity among children and adolescents. The results of the study may be used as a basis for the development of more preventive and health promoting physical planning.

The intervention
The intervention will comprise four areas. The intervention areas will be aimed at: (1) Active transport, (2) The school’s outdoor areas, (3) Playspots, and (4) Organised physical fitness. For each of the intervention areas, a number of physical improvements will be implemented in the districts to either modify existing structures or to establish new ones. Furthermore, the physical structural enhancement, distributed on the interventions, will be followed up by organisational interventions that support the possibilities of activity by use of, for instance, activity assistants, changed access conditions or traffic action plans. It is a common feature of the intervention areas that they will
be manageable for a municipality to establish and maintain as far as size and financial level are concerned.

Design
The prevention intervention will be carried out in close cooperation with the Region of Southern Denmark and municipalities in the region. The intervention will include 6-8 municipalities who wish to participate in the project on the basis of the premises laid down. In each of the participating municipalities two districts will be selected. An intervention district where the intervention areas will be implemented, and a control district which corresponds to the intervention district in relation to urbanisation, area utilisation, and demographic composition.

Impact measurement and assessment
The impact of the intervention areas will be measured by making registrations before and after the implementation of interventions, which will be compared with similar registrations in the control districts. The registrations will be distributed on: (1) Accelerometer measurements, which are an objective measurement for physical activity, (2) The Andersen Test, which is an objective measurement for physical fitness level, (3) E-survey, which collects self-reported data on behaviour in the local environment, and (4) Counts and observational studies providing data on extent and use distributed on the four intervention areas. Concurrently with the impact measurements, health economic calculations and process analyses will be made, which generate knowledge on the conditions for appropriate implementation of structural interventions in Danish municipalities.

Time schedule
The project runs for five years with the following milestones:

2009: Intervention and control districts to be established.
2010: Baseline studies to be carried out.
Interventions to be implemented.
2011: Analysis of baseline studies.
2012: Impact of interventions to be registered.
2013: Project reporting.